Mecklenburg Medical Group

NPI #1144545583 in Charlotte, North Carolina

Provider Information

NPI Number: 1144545583
Entity Type: Organization
Organization Name: Mecklenburg Medical Group
Primary Specialty: Internal Medicine
Enumeration Date: Mar 29, 2010
Last Updated: Mar 29, 2010

Practice Location

Address: 1900 BRUNSWICK AVE
City: Charlotte
State: North Carolina
ZIP Code: 28207-1822
Phone: (704) 358-4400

Authorized Official

Name: DANIEL L WIENS
Title: SENIOR VICE PRESIDENT
Phone: (704) 355-0648

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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